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General NPI Number Information
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NPI Number | 1447432075
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Entity Type | Individual
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Provider Name | JO ANNA BENSON LPC
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Gender | Female
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Dates
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Enumeration Date | 12/05/2007
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 925 S BROADWAY STE 100
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City | CORTEZ
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State | CO
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Zip | 81321
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Country | US
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Telephone | 970-560-7323
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Fax |
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Provider Business Mailing Address
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Address Line | 15248 ROAD 22
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City | DOLORES
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State | CO
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Zip | 81323-9117
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Country | US
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Telephone | 970-560-3942
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4279
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License Number State | OK
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